{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T05:53:58Z","timestamp":1785477238461,"version":"3.56.0"},"reference-count":71,"publisher":"Public Library of Science (PLoS)","issue":"8","license":[{"start":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T00:00:00Z","timestamp":1756166400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"The Administration of Traditional Chinese Medicine of Guangdong Province, China","award":["202304280912411140; 20241091"],"award-info":[{"award-number":["202304280912411140; 20241091"]}]},{"name":"Guangzhou Municipal Health Commission","award":["2023P-TS49"],"award-info":[{"award-number":["2023P-TS49"]}]},{"name":"Guangzhou Science and Technology Plan Project, China","award":["2023B03J0379; 2024A04J3774"],"award-info":[{"award-number":["2023B03J0379; 2024A04J3774"]}]},{"name":"Chinese Society of Traditional Chinese Medicine Youth Talent Lifting Project","award":["2022-QNRC2-B11"],"award-info":[{"award-number":["2022-QNRC2-B11"]}]},{"name":"The Hospital Young and Middle Aged Key Talent Cultivation Project of The First Affiliated Hospital of Guangzhou University of Traditional Chinese Medicine","award":["2023.10"],"award-info":[{"award-number":["2023.10"]}]},{"name":"Guangdong Provincial Administration of Traditional Chinese Medicine Research Project","award":["20251106"],"award-info":[{"award-number":["20251106"]}]}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Objective<\/jats:title>\n<jats:p>To appraise the clinical effectiveness and complications of two surgical approaches, namely decompression alone (DA) versus decompression with interbody fusion (DF), in managing degenerative lumbar diseases (DLD).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methods<\/jats:title>\n<jats:p>As of July 1, 2024, an exhaustive search identified all randomized controlled studies and cohort studies comparing DA and DF in DLD management. Relevant data were extracted using strict criteria, and study quality was assessed via the Newcastle-Ottawa Scale and Cochrane Collaboration\u2019s tool. The extracted outcomes encompassed a range of measures, including operative duration, intraoperative hemorrhage, hospitalization length, time to ambulation, short form 12 physical component score (SF12-PCS), low back pain visual analog scale (VAS) score, leg pain VAS score, Oswestry disability index (ODI), Japanese orthopedic association (JOA) score, EuroQol five dimensions (EQ-5D), incidence of complications, reoperation rate, and Odom\u2019s criteria.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Results<\/jats:title>\n<jats:p>A total of 35 articles were included in this study, involving 12,030 patients. Of these, 7,442 patients were in the DA group, while 4,588 were in the DF group. Operative duration was shorter (MD\u2009=\u2009\u221289.09, 95%CI \u221292.71, \u221285.47, <jats:italic><jats:italic>P<\/jats:italic><\/jats:italic>\u2009&lt;\u20090.00001), intraoperative hemorrhage was less (MD\u2009=\u2009\u2212242.26, 95%CI \u2212252.16, \u2212232.36, <jats:italic><jats:italic>P<\/jats:italic><\/jats:italic>\u2009&lt;\u20090.00001), hospitalization length was shorter (MD\u2009=\u2009\u22122.36, 95%CI \u22122.59, \u22122.14, <jats:italic><jats:italic>P<\/jats:italic><\/jats:italic>\u2009&lt;\u20090.00001), and time to ambulation was reduced (MD\u2009=\u2009\u221210.49, 95%CI \u221212.52, \u22128.46, <jats:italic><jats:italic>P<\/jats:italic><\/jats:italic>\u2009&lt;\u20090.00001) in the DA group than in the DF group. At the final follow-up for ODI, the DF group demonstrated statistically superior outcomes compared to the DA group (MD\u2009=\u20091.28, 95%CI 0.35, 2.21, <jats:italic><jats:italic>P<\/jats:italic>\u2009<\/jats:italic>=\u20090.007). Data revealed no significant differences in SF12-PCS, JOA score, back pain VAS score, leg pain VAS score, final follow-up EQ-5D, reoperation rates, complication rates, and Odom\u2019s criteria (<jats:italic><jats:italic>P<\/jats:italic>\u2009<\/jats:italic>&gt;\u20090.05).<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec004\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>When treating DLD, DA offers more favorable outcomes in terms of operative duration, intraoperative hemorrhage, hospitalization length, and time to ambulation. These findings suggest that DA should be considered the preferred surgical approach for most DLD patients, unless specific indications for fusion exist. Clinicians should tailor decisions to each surgery\u2019s specifics to optimize patient outcomes.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec005\">\n<jats:title>Trial registration<\/jats:title>\n<jats:p>PROSPERO registration number: CRD42024580975.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pone.0330926","type":"journal-article","created":{"date-parts":[[2025,8,26]],"date-time":"2025-08-26T17:25:32Z","timestamp":1756229132000},"page":"e0330926","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":1,"title":["Decompression with interbody fusion versus decompression alone for degenerative lumbar diseases: A meta-analysis"],"prefix":"10.1371","volume":"20","author":[{"given":"Yuxian","family":"Chen","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shenglin","family":"Lei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Lin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yilin","family":"Huang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Pinying","family":"Cheng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuling","family":"Gu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4313-8184","authenticated-orcid":true,"given":"Dongping","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2025,8,26]]},"reference":[{"issue":"3","key":"pone.0330926.ref001","doi-asserted-by":"crossref","first-page":"599","DOI":"10.1177\/21925682211000707","article-title":"Epidemiology of Lumbar Degenerative Phenotypes of Children and Adolescents: A Large-Scale Imaging Study","volume":"13","author":"ZY Wan","year":"2023","journal-title":"Global Spine J"},{"issue":"1","key":"pone.0330926.ref002","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1186\/s40001-021-00622-7","article-title":"Associations between facet tropism and vertebral rotation in patients with degenerative lumbar disease","volume":"26","author":"Y Ma","year":"2021","journal-title":"Eur J Med Res"},{"key":"pone.0330926.ref003","doi-asserted-by":"crossref","DOI":"10.1227\/NEU.0000000000000950","article-title":"The Burden of Spinal Disorders in the Elderly","volume":"77","author":"R Waldrop","year":"2015","journal-title":"Neurosurgery"},{"issue":"13","key":"pone.0330926.ref004","first-page":"440","article-title":"Lumbar Disc Herniation\u2014the Significance of Symptom Duration for the Indication for Surgery","volume":"121","author":"N K\u00f6gl","year":"2024","journal-title":"Dtsch Arztebl Int"},{"issue":"37","key":"pone.0330926.ref005","first-page":"613","article-title":"Degenerative lumbar spinal stenosis in older people: current treatment options","volume":"110","author":"R Kalff","year":"2013","journal-title":"Dtsch Arztebl Int"},{"issue":"5","key":"pone.0330926.ref006","doi-asserted-by":"crossref","first-page":"945","DOI":"10.1007\/s00586-013-3144-3","article-title":"Surgery in lumbar degenerative spondylolisthesis: indications, outcomes and complications. 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